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Training Collections
Library Memberships
On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Unlock access to our full Course Library and all self-paced Fellowships.
Continuing Medical Education (State CME)
Complete all of your state CME requirements in one convenient place.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Case Crunch: Rapid Case Review (Free)
Register for free live board reviews.
Dr. Resnick's MSK Conference
Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Compliance
NewTrack, fulfill, and report on all your radiologists' credentialing and licensing requirements.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
4 topics, 10 min.
10 topics, 19 min.
17 topics, 1 hr. 11 min.
Anterior Globe Rupture with Laterally Dislocated Cataract
4 m.Foreign Body in Globe
4 m.Wood Foreign Body and Ocular Hypotony
2 m.Hemmorhage in Both Chambers, Open Globe
3 m.Staphyloma
4 m.Persistent Hyperplastic Primary Vitreous (PHPV)
5 m.Retinal Detachment
3 m.Retinoblastoma on CT
4 m.Retinoblastoma on MRI
9 m.Bilateral Retinoblastoma
7 m.Ocular Pathology - Review
11 m.Endophthalmitis
3 m.PHPV Review, Coloboma, and Staphyloma
5 m.Phthisis Bulbi, Macrophthalmia, and Microphthalmia
4 m.Ocular Calcification
4 m.Retinoblastoma - Review
5 m.Choroidal Melanoma
3 m.15 topics, 1 hr. 8 min.
Intraconal, Conal and Extraconal Anatomy
1 m.Intraconal Hemangioma
5 m.Venous Vascular Malformation
3 m.Optic Nerve Glioma, NF1
4 m.Optic pathway glioma (pilocytic astrocytoma)
4 m.Optic Neuritis, Multiple Sclerosis
6 m.Optic Neuritis, Multiple Sclerosis (2)
7 m.Neuromyelitis Optica Spectrum Disorder
5 m.Neuromyelitis Optica With Spinal Cord Involvement
3 m.Optic Nerve Sheath Meningioma
5 m.Bilateral Optic Neuritis, Leukemia
6 m.Intraconal Pathology - Review
11 m.Optic Neuritis - Review
5 m.Optic Nerve Glioma - Review
4 m.Optic Nerve Sheath Meningioma - Review
6 m.5 topics, 16 min.
18 topics, 55 min.
Extraconal Pathology - Introduction
1 m.Periorbital Cellulitis & Abscess
4 m.Type 3 Orbital Infection
3 m.Solitary Fibrous Tumor
4 m.Langerhans Cell Histiocytosis
2 m.Juvenile Ossifying Fibroma
2 m.Perineural Spread of Squamous Cell Carcinoma
5 m.Proptosis from Extraosseous Extension of Prostate Metastasis
3 m.Orbital Floor Fracture
5 m.Orbital Floor Fracture with Muscle/Fat Herniation
4 m.Orbital Floor Fracture: Status Post Repair
2 m.Bilateral Orbital Fracture Repair
2 m.Periorbital Cellulitis - Review
5 m.Orbital Pseudotumor - Review
3 m.Orbital Wall Abnormalities - Review
3 m.Orbital Fracture - Review
7 m.Giant Cell Reparative Granuloma
3 m.Granulomatous Sinusitis with IgG4-related Ophthalmic Disease
4 m.6 topics, 19 min.
0:01
As you can see by this slide,
0:03
the differential diagnosis for things that
0:06
cause ocular calcification is very broad.
0:10
I've labeled them in part under groupings
0:14
of degenerative hypercalcemic states,
0:19
neoplastic and infectious etiologies.
0:23
The most common cause for an ocular calcification is what
0:28
we call senescent calcifications at muscular
0:31
tenderness insertion sites on the globe.
0:35
These are normal phenomenon and should not even be
0:38
reported as abnormalities within the findings of a report.
0:43
Similarly,
0:44
optic nerve head drusen
0:48
are also degenerative processes that are very common,
0:54
that are asymptomatic. We already mentioned
0:58
the entity of phthisis bulbi.
1:00
And phthisis bulbi is associated with the microphthalmia.
1:04
So if we think about those things that were on both the
1:09
previous slide of the causes of microphthalmus,
1:13
as well as those with ocular calcification,
1:16
one may see some of these include things like retinopathy
1:19
of prematurity or a late stage of retinal detachment.
1:23
But phthisis bulbi is going to be very common.
1:27
Cataracts
1:29
may eventually calcify if they get too ripe,
1:35
and this is lens degenerative phenomenon
1:40
seen in the elderly.
1:42
Anything that causes dysmetabolism of the calcium
1:45
phosphorus balance can lead to ocular calcification
1:51
of the ocular membranes. Within the neoplastic category,
1:56
far and away, the most common is going to be the
1:59
retinoblastoma, that childhood neoplasm,
2:04
the other entities are very uncommon.
2:08
Finally, we have infection,
2:10
and I mentioned previously that TORCH
2:12
infections may lead to microphthalmos as well,
2:17
and you can see some of them here.
2:19
However,
2:20
toxocara infection, sarcoidosis, things that can cause
2:24
granulomas of the globe,
2:26
may also cause ocular calcification.
2:30
I mentioned optic nerve head drusen.
2:33
Although these are typically asymptomatic,
2:36
they can lead to some difficulty from the standpoint
2:40
of the ophthalmologic finding.
2:43
This is because, although the ophthalmologists note that
2:46
there is an abnormality at the optic nerve head insertion,
2:50
they cannot tell that this is calcification,
2:53
and therefore,
2:53
it may simulate papilledema and be
2:57
a cause of what is known as pseudopapilledema,
3:00
that is the protrusion of the optic nerve head.
3:03
On CT scan,
3:05
this is identified by the calcification
3:07
as a normal phenomenon of aging.
3:10
Far and away, the entity that is most concerning with
3:14
regard to ocular calcification is retinoblastoma.
Interactive Transcript
0:01
As you can see by this slide,
0:03
the differential diagnosis for things that
0:06
cause ocular calcification is very broad.
0:10
I've labeled them in part under groupings
0:14
of degenerative hypercalcemic states,
0:19
neoplastic and infectious etiologies.
0:23
The most common cause for an ocular calcification is what
0:28
we call senescent calcifications at muscular
0:31
tenderness insertion sites on the globe.
0:35
These are normal phenomenon and should not even be
0:38
reported as abnormalities within the findings of a report.
0:43
Similarly,
0:44
optic nerve head drusen
0:48
are also degenerative processes that are very common,
0:54
that are asymptomatic. We already mentioned
0:58
the entity of phthisis bulbi.
1:00
And phthisis bulbi is associated with the microphthalmia.
1:04
So if we think about those things that were on both the
1:09
previous slide of the causes of microphthalmus,
1:13
as well as those with ocular calcification,
1:16
one may see some of these include things like retinopathy
1:19
of prematurity or a late stage of retinal detachment.
1:23
But phthisis bulbi is going to be very common.
1:27
Cataracts
1:29
may eventually calcify if they get too ripe,
1:35
and this is lens degenerative phenomenon
1:40
seen in the elderly.
1:42
Anything that causes dysmetabolism of the calcium
1:45
phosphorus balance can lead to ocular calcification
1:51
of the ocular membranes. Within the neoplastic category,
1:56
far and away, the most common is going to be the
1:59
retinoblastoma, that childhood neoplasm,
2:04
the other entities are very uncommon.
2:08
Finally, we have infection,
2:10
and I mentioned previously that TORCH
2:12
infections may lead to microphthalmos as well,
2:17
and you can see some of them here.
2:19
However,
2:20
toxocara infection, sarcoidosis, things that can cause
2:24
granulomas of the globe,
2:26
may also cause ocular calcification.
2:30
I mentioned optic nerve head drusen.
2:33
Although these are typically asymptomatic,
2:36
they can lead to some difficulty from the standpoint
2:40
of the ophthalmologic finding.
2:43
This is because, although the ophthalmologists note that
2:46
there is an abnormality at the optic nerve head insertion,
2:50
they cannot tell that this is calcification,
2:53
and therefore,
2:53
it may simulate papilledema and be
2:57
a cause of what is known as pseudopapilledema,
3:00
that is the protrusion of the optic nerve head.
3:03
On CT scan,
3:05
this is identified by the calcification
3:07
as a normal phenomenon of aging.
3:10
Far and away, the entity that is most concerning with
3:14
regard to ocular calcification is retinoblastoma.
Report
Description
Faculty
David M Yousem, MD, MBA
Professor of Radiology, Vice Chairman and Associate Dean
Johns Hopkins University
Tags
Vascular
Trauma
Orbit
Non-infectious Inflammatory
Neuroradiology
Neuro
Neoplastic
Metabolic
MRI
Infectious
Head and Neck
Congenital
CT
Acquired/Developmental
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